Organization
MEDEXPRESS URGENT CARE PC - INDIANA
Active
Other names
MedExpress Urgent Care - Southport
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM G BUGIN (VP OF PAYOR CONTRACTING)
(304) 225-2500
Entity
Organization
Contact information
Practice address
7225 US 31 S, SUITE G, INDIANAPOLIS, IN 46227-8685
(317) 859-1156
(317) 859-1192
Mailing address
1001 CONSOL ENERGY DR, CANONSBURG, PA 15317-6506
(304) 225-2500
(724) 743-1133
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201134900G
—
IN
Enumeration date
05/01/2013
Last updated
09/08/2016
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